Aggiornamento monografico
Il disturbo di attenzione con iperattività
ATTENTION DEFICIT HYPERACTIVITY DISORDER
VINCENZO NUZZO
Pediatra di Famiglia, Psicoterapeuta, ASL 48, Napoli
Novembre 2001 - pagg. 581 -594
Abstract
The ADHD is a neuropsychiatric disorder with childhood onset. Over the last decades,
ADHD has been often confused with the so called hyperactivity syndrome which includes
various functional or organic disorders with multifactorial causes. As a consequence, children
with the ADHD have been frequently misdiagnosed and inappropriately managed.
The article reviews the etiology of ADHD and the available evidence about the efficacy of
pharmacological treatment, with specific attention paid to methylphenidate. Criteria for
diagnosis of ADHD are presented and discussed as well as the the complexity of the of
ADHD on the family environment, that must be taken into account in the management plan.
Finally, the Author discusses the role of the paediatrician in the diagnosis and management,
which need to be carried out in close collaboration with other professionals and specialists.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Nuzzo V. Il bambino “troppo nervoso”, ovvero
il bambino “onnipotente”, e il Pediatra di
Famiglia. Il Medico Pediatra 2001; 9(6):453-
61.
2. Costello EJ, Edelbrock C, Costello AJ, Dulcan MK, Burns BJ, Brent D. Psychopathology in pediatric primary care: the new hidden morbidity. Pediatrics 1988;82:415-24.
3. Am Acad of Child and Adolescent Psychiatry AACAP official action. Practice parameter for the assessment and treatment of children and adolescent with conduct disorders. J Am Acad Child Adolesc Psychiatry 1997;36(suppl): 122-39.
4. Am Acad of Child and Adolescent Psychiatry. Conduct disorders 33 (11), 1995 (sito web).
5. Matejcek Z. Begriff der psychischen Subdeprivation. Sozialpädiatrie 1988;7:488-96.
6. Nuzzo V. Un vuoto educativo coperto di premure. Occhio Clinico Pediatria 1999;7:50.
7. Nuzzo V. Dimensione simbolico-culturale dell’inappetenza del bambino. Medico e Bambino 1995;4:45.
8. Nuzzo V. La diade perversa. Il Medico Pediatra 2000;9(5):368-73.
9. Levi R, Penge G. Il rischio psicopatologico in età evolutiva: problemi emergenti. Psichiatria dell’Infanzia e dell’Adolescenza 1996; 63:55-67.
10. Pliszka SR. The use of psychostimulants in the pediatric patient. Ped Clin of North Am 1998;45(5):1084-98.
11. Döpfner M, Fröhlic J, Lehmkühl G. Hyperkinetische Störungen. Göttingen: Hogrefe Verlag, 2000.
12. Am Acad of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics 2000;105(5):1158-70.
13. Kidd PM. Attention Deficit/Hyperactivity Disorder (ADHD) in Children: rationale for its integrative management. Altern Med Rev 2000;5(5):402-28.
14. NHI. Diagnosis and treatment of attention deficit hyperactivity disorder (ADHD). NHI Consensus Statement 1998, Nov 16-18; 16(2):1-37.
15. Meaux JB. Stop, look and listen: the challenge for children with ADHD. Issues Compr Pediatr Nurs 2000;23(1):1-13.
16. Hetchman L. Assessment and diagnosis of attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000; 9(3):481-98.
17. Mannuzza S, Klein RG. Long-term prognosis in attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000;9(3):711-26.
18. Rasmussen P, Gillberg C. Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Adolesc Psychiatry 2000; 39(11):1424-31.
19. Zuddas A, Ancilletta B, Muglia P, Cianchetti C. Attention-deficit/hyperactivity disorder: a neuropsychiatric disorder with childhood onset. Europ J Paediatr Neurol 2000;4(2):53-62.
20. Lie N. Follow-ups of children with attention deficit hyperactivity disorder (ADHD). Review of literature. Acta Psychiatr Scand Suppl 1992;368:1-40.
21. Editorial. Evidence and belief in ADHD. BMJ 2000;321:975-6.
22. Long-term outcome studies of hyperactive children: literature review. Kao Hsiung I Hsueh Ko Hsueh Tsa Chih 1999;15(6):307-14 (abstract).
23. May B, Bos J. Personality characteristics of ADHD adults assessed with the Million Clinical Multiaxial Inventory-II: evidence of four distinct subtypes. J Pers Assess 2000; 75(2):237-48.
24. Scahill L, Schwab-Stone M. Epidemiology of ADHD in school-age children. Child Adolesc Psychiatr Clin N Am 2000;9(3):541-5.
25. Guardiola A, Fuchs FD, Rotta NT. Prevalence of attention-deficit hyperactivity disorders in student. Comparison between DSMIV and neuropsychological criteria. Arch Neuropsiquiatr 2000;58(2B):401-7.
26. Vio C, Marzocchi G, Offredi F. Il bambino con deficit di attenzione/iperattività. Erikson 1999:17.
27. Barkley RA. Deficit di attenzione e iperattività. Le Scienze 1999;365:70-6.
28. Hüwer HD. Aufmerksamkheitsstörung als Stoffwechselstörung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow-Klinikum 9.10-11.10.98.
29. Kühle HJ. Neurophysiologische Grundlagen der Aufmerksamkheitsstörung und seiner medikamentösen Behandlung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow- Klinikum 9.10-11.10.98
30. Barkley RA). ADHD and nature of self control. New York: Guilgord Press, 1997.
31. Biedermann J, Faraone SV, Mick E, Spenser T, et al. High risk for attention deficit hyperactivity disorder among children of parents with childhood onset of the disorder. A pilot study. Am J of Psych 1995;152:431-5.
32. Moll GH, Rothenberger A. Neurobiologische Grundlagen. Ein pathophysiologisches Erklärungsmodell der ADHD. Kinderärztliche Praxis, Sonderhef.t 2001:.9-15.
33. De Wolfe NA, Byrne JM, Bawden HN. Early clinical assessment of attention. Clin Neuropsychol 1999;13(4 :458-73.
34. Feingold BF. Why your child is hyperactive. New York: Random House, 1975.
35. Ventura A, Carrozzi M, Mammano ML, Martelossi S. Difetto di attenzione con iperattività: esperienze con la dieta di eliminazione. Medico e Bambino 1994;4:36.
36. Pastor D. Answering parental questions. Symposium conducted af the meeting of Minnesota Association for Children with Learning Disabilities. Minneapolis, USA: aprile 1987.
37. Marshall P. Attention deficit disorder and allergy: A neurochemical model of the relation between the illness. Psychological Bullettin 1989;6:434-46.
38. Block SL. Attention Deficit Disorder: a paradigm for psychotropic medication intervention in pediatrics. Ped Clin of North Am 1998;45(5:1053-84.
39. Byrne JM, Bawden HN, Beattie TL, De Wolfe NA. Preschoolers classified as having attention-deficit hyperactivity disorder (ADHD). DSM-IV symptom endorsement patterns. J Child Neurol 2000;15(8):533-8.
40. Brickenkamp R. Test d2 Aufmerksamkheits- Belastungs-Test. Testzentrale. Göttingen: Hogrefe Verlag, 2000.
41. Kleber EW, Kleber G. Differenzielleer Leistungstest- KE e -KG. Testzentrale. Göttingen: Hogrefe Verlag, 2000.
42. Jansen F. Komplexität des klinischen Erscheinungsbildes der Aufmerksamkheitsstörung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow-Klinikum 9.10-11.10.98.
43. Oliverio-Ferraris A, Bellacicco D, Costabile A, Sasso S. Lo sviluppo sociale e morale nella seconda e terza infanzia. In: Oliverio- Ferraris A, Bellacicco D, Costabile A, Sasso S. Introduzione alla psicologia dello sviluppo. Laterza, 1997: 256.
44. Vegetti-Finzi S, Battistin AM. Educazione e carattere. In: Vegetti-Finzi S, Battistin AM. I bambini sono cambiati. Milano: Mondadori, 1996:196.
45. Wassermann RC, Kelleher KJ, Bocian A, Baker A, Childs GE, Indacochea F, Stulp C, Gardner WP. Identification of attention and hyperactivity problems in primary care: a report from pediatric research in office setting and the ambulatory sentinel practice network. Pediatrics 1999;103(3):38 (pagine elettroniche).
46. Abikoff H, Klein RG. Attention-deficit hyperactivity and conduct disorder. J Consult Clin Psych 1992;60:881-92.
47. Jansen F, Streit U. Eltern als Therapeuten. Berlin Heidelberg: Springer Verlag, 1993.
48. Posteraro F, Luccherino L, Milone A, Pfanner P. L’instabilità motoria: una sindrome neuropsichiatrica. Medico e Bambino 1994; 4:32.
49. Jellinek MS. L’intervista nella pratica pediatrica ambulatoriale. Current Problems in Pediatrics (ed ital).
50. Jellinek MS, Murphy IM. L’uso della lista di controllo dei sintomi nella pratica pediatrica. Current problems in Pediatrics (ed ital).
51. Aggarwal A, Lillystone D. A follow-up pilot study of objective measures in children with attention decifit hyperactivity disorder. J Paediatr Child Health 2000;36(2):134-8.
52. Weinberg HA. Parent training for attention- deficit hyperactivity disorder: parentale and child outcome. J Clin Psychol 1999; 55(7):907-13.
53. Shelton TL, Barkley RA, Crosswait C, Moorehouse M, Fletcher K, Barret S, Jenkins L, Metevia L. Multimethod psychoeducational intervention for preschool children with disruptive behavior: two-year post-treatment follow-up. J Abnorm Child Psychol 2000; 28(3):253-66.
54. Jadad AR, Booker L, Gauld M, Kakuma R, Boyle M, Cunningham CE, Kim M, Schachar R. The treatment of attention-deficit hyperactivity disorder: an annotate bibliography and critical appraisal of published systematic reviews and metanalyses. Can J Psychiatry 1999;44(10):1025-35.
55. Cunningham CE. In the wake of MTA: charting a mew course for the study and treatment of children with attention-deficit hyperactivity disorder. Can J Psychiatry 1999; 44(10):999-1006.
56. Pelham WE, Carlson C, Sams SE, Vallano G, Dixon MJ, Hoza B. Separate and combinaned effects of methylphenidate and behavior modification on boys with ADHD in the classroom. J Consult Clin Psychol 1993; 61:506- 15.
57. Safer DJ. Principali considerazioni terapeutiche per il disturbo da deficit dell’attenzione con iperattività. Current Problems in Pediatrics (ed ital), Apr-Ago 95, pag 273-86.
58. Hoffman JB, DuPaul GJ. Psychoeducational interventions for children and adolescents with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000; 9(3):647-61.
59. Pliszka SR, Greenhill LL, Crismon ML, Sedillo A, Carlson C, Conners CK, Mc Cracken JT, Swanson JM, Hughes CW, Llana ME, Lopez M, Toprac MG. The Texas children’s medication algorithm project: report of the Texas consensus conference panel on medication treatment of childhood attention deficit/hyperactivity disorder. Part I. Attention deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2000;39(7):908-19.
60. Bonney H. Treatment of children with hyperkinetic disorders (ADHD) based on communications- and systems analysis. Prax Kinderpsychol Kinderpsychiatr 2000;49(4):285- 99.
61. Hüwer HD. Medikamentöse Therapie der Aufmerksamkheitsstörung bei Kindern. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow- Klinikum 9.10-11.10.98.
62. von Voss H. Kinder entlasten und Eltern befreien. Kinderärztliche Praxis, Sonderheft 2001:3.
63. Smikalla WD. Individuelle medikamentöse Einstellung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow-Klinikum 9.10-11.10.98.
64. Nuzzo V. Lettera al Ministro della Sanità. Forum di Pediatria On Line, ottobre 2000.
65. Martini N. Risposta del Ministro della Sanità alla petizione di Nuzzo sul metilfenidato. Forum di Pediatria On Line, ottobre 2000.
2. Costello EJ, Edelbrock C, Costello AJ, Dulcan MK, Burns BJ, Brent D. Psychopathology in pediatric primary care: the new hidden morbidity. Pediatrics 1988;82:415-24.
3. Am Acad of Child and Adolescent Psychiatry AACAP official action. Practice parameter for the assessment and treatment of children and adolescent with conduct disorders. J Am Acad Child Adolesc Psychiatry 1997;36(suppl): 122-39.
4. Am Acad of Child and Adolescent Psychiatry. Conduct disorders 33 (11), 1995 (sito web).
5. Matejcek Z. Begriff der psychischen Subdeprivation. Sozialpädiatrie 1988;7:488-96.
6. Nuzzo V. Un vuoto educativo coperto di premure. Occhio Clinico Pediatria 1999;7:50.
7. Nuzzo V. Dimensione simbolico-culturale dell’inappetenza del bambino. Medico e Bambino 1995;4:45.
8. Nuzzo V. La diade perversa. Il Medico Pediatra 2000;9(5):368-73.
9. Levi R, Penge G. Il rischio psicopatologico in età evolutiva: problemi emergenti. Psichiatria dell’Infanzia e dell’Adolescenza 1996; 63:55-67.
10. Pliszka SR. The use of psychostimulants in the pediatric patient. Ped Clin of North Am 1998;45(5):1084-98.
11. Döpfner M, Fröhlic J, Lehmkühl G. Hyperkinetische Störungen. Göttingen: Hogrefe Verlag, 2000.
12. Am Acad of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics 2000;105(5):1158-70.
13. Kidd PM. Attention Deficit/Hyperactivity Disorder (ADHD) in Children: rationale for its integrative management. Altern Med Rev 2000;5(5):402-28.
14. NHI. Diagnosis and treatment of attention deficit hyperactivity disorder (ADHD). NHI Consensus Statement 1998, Nov 16-18; 16(2):1-37.
15. Meaux JB. Stop, look and listen: the challenge for children with ADHD. Issues Compr Pediatr Nurs 2000;23(1):1-13.
16. Hetchman L. Assessment and diagnosis of attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000; 9(3):481-98.
17. Mannuzza S, Klein RG. Long-term prognosis in attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000;9(3):711-26.
18. Rasmussen P, Gillberg C. Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Adolesc Psychiatry 2000; 39(11):1424-31.
19. Zuddas A, Ancilletta B, Muglia P, Cianchetti C. Attention-deficit/hyperactivity disorder: a neuropsychiatric disorder with childhood onset. Europ J Paediatr Neurol 2000;4(2):53-62.
20. Lie N. Follow-ups of children with attention deficit hyperactivity disorder (ADHD). Review of literature. Acta Psychiatr Scand Suppl 1992;368:1-40.
21. Editorial. Evidence and belief in ADHD. BMJ 2000;321:975-6.
22. Long-term outcome studies of hyperactive children: literature review. Kao Hsiung I Hsueh Ko Hsueh Tsa Chih 1999;15(6):307-14 (abstract).
23. May B, Bos J. Personality characteristics of ADHD adults assessed with the Million Clinical Multiaxial Inventory-II: evidence of four distinct subtypes. J Pers Assess 2000; 75(2):237-48.
24. Scahill L, Schwab-Stone M. Epidemiology of ADHD in school-age children. Child Adolesc Psychiatr Clin N Am 2000;9(3):541-5.
25. Guardiola A, Fuchs FD, Rotta NT. Prevalence of attention-deficit hyperactivity disorders in student. Comparison between DSMIV and neuropsychological criteria. Arch Neuropsiquiatr 2000;58(2B):401-7.
26. Vio C, Marzocchi G, Offredi F. Il bambino con deficit di attenzione/iperattività. Erikson 1999:17.
27. Barkley RA. Deficit di attenzione e iperattività. Le Scienze 1999;365:70-6.
28. Hüwer HD. Aufmerksamkheitsstörung als Stoffwechselstörung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow-Klinikum 9.10-11.10.98.
29. Kühle HJ. Neurophysiologische Grundlagen der Aufmerksamkheitsstörung und seiner medikamentösen Behandlung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow- Klinikum 9.10-11.10.98
30. Barkley RA). ADHD and nature of self control. New York: Guilgord Press, 1997.
31. Biedermann J, Faraone SV, Mick E, Spenser T, et al. High risk for attention deficit hyperactivity disorder among children of parents with childhood onset of the disorder. A pilot study. Am J of Psych 1995;152:431-5.
32. Moll GH, Rothenberger A. Neurobiologische Grundlagen. Ein pathophysiologisches Erklärungsmodell der ADHD. Kinderärztliche Praxis, Sonderhef.t 2001:.9-15.
33. De Wolfe NA, Byrne JM, Bawden HN. Early clinical assessment of attention. Clin Neuropsychol 1999;13(4 :458-73.
34. Feingold BF. Why your child is hyperactive. New York: Random House, 1975.
35. Ventura A, Carrozzi M, Mammano ML, Martelossi S. Difetto di attenzione con iperattività: esperienze con la dieta di eliminazione. Medico e Bambino 1994;4:36.
36. Pastor D. Answering parental questions. Symposium conducted af the meeting of Minnesota Association for Children with Learning Disabilities. Minneapolis, USA: aprile 1987.
37. Marshall P. Attention deficit disorder and allergy: A neurochemical model of the relation between the illness. Psychological Bullettin 1989;6:434-46.
38. Block SL. Attention Deficit Disorder: a paradigm for psychotropic medication intervention in pediatrics. Ped Clin of North Am 1998;45(5:1053-84.
39. Byrne JM, Bawden HN, Beattie TL, De Wolfe NA. Preschoolers classified as having attention-deficit hyperactivity disorder (ADHD). DSM-IV symptom endorsement patterns. J Child Neurol 2000;15(8):533-8.
40. Brickenkamp R. Test d2 Aufmerksamkheits- Belastungs-Test. Testzentrale. Göttingen: Hogrefe Verlag, 2000.
41. Kleber EW, Kleber G. Differenzielleer Leistungstest- KE e -KG. Testzentrale. Göttingen: Hogrefe Verlag, 2000.
42. Jansen F. Komplexität des klinischen Erscheinungsbildes der Aufmerksamkheitsstörung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow-Klinikum 9.10-11.10.98.
43. Oliverio-Ferraris A, Bellacicco D, Costabile A, Sasso S. Lo sviluppo sociale e morale nella seconda e terza infanzia. In: Oliverio- Ferraris A, Bellacicco D, Costabile A, Sasso S. Introduzione alla psicologia dello sviluppo. Laterza, 1997: 256.
44. Vegetti-Finzi S, Battistin AM. Educazione e carattere. In: Vegetti-Finzi S, Battistin AM. I bambini sono cambiati. Milano: Mondadori, 1996:196.
45. Wassermann RC, Kelleher KJ, Bocian A, Baker A, Childs GE, Indacochea F, Stulp C, Gardner WP. Identification of attention and hyperactivity problems in primary care: a report from pediatric research in office setting and the ambulatory sentinel practice network. Pediatrics 1999;103(3):38 (pagine elettroniche).
46. Abikoff H, Klein RG. Attention-deficit hyperactivity and conduct disorder. J Consult Clin Psych 1992;60:881-92.
47. Jansen F, Streit U. Eltern als Therapeuten. Berlin Heidelberg: Springer Verlag, 1993.
48. Posteraro F, Luccherino L, Milone A, Pfanner P. L’instabilità motoria: una sindrome neuropsichiatrica. Medico e Bambino 1994; 4:32.
49. Jellinek MS. L’intervista nella pratica pediatrica ambulatoriale. Current Problems in Pediatrics (ed ital).
50. Jellinek MS, Murphy IM. L’uso della lista di controllo dei sintomi nella pratica pediatrica. Current problems in Pediatrics (ed ital).
51. Aggarwal A, Lillystone D. A follow-up pilot study of objective measures in children with attention decifit hyperactivity disorder. J Paediatr Child Health 2000;36(2):134-8.
52. Weinberg HA. Parent training for attention- deficit hyperactivity disorder: parentale and child outcome. J Clin Psychol 1999; 55(7):907-13.
53. Shelton TL, Barkley RA, Crosswait C, Moorehouse M, Fletcher K, Barret S, Jenkins L, Metevia L. Multimethod psychoeducational intervention for preschool children with disruptive behavior: two-year post-treatment follow-up. J Abnorm Child Psychol 2000; 28(3):253-66.
54. Jadad AR, Booker L, Gauld M, Kakuma R, Boyle M, Cunningham CE, Kim M, Schachar R. The treatment of attention-deficit hyperactivity disorder: an annotate bibliography and critical appraisal of published systematic reviews and metanalyses. Can J Psychiatry 1999;44(10):1025-35.
55. Cunningham CE. In the wake of MTA: charting a mew course for the study and treatment of children with attention-deficit hyperactivity disorder. Can J Psychiatry 1999; 44(10):999-1006.
56. Pelham WE, Carlson C, Sams SE, Vallano G, Dixon MJ, Hoza B. Separate and combinaned effects of methylphenidate and behavior modification on boys with ADHD in the classroom. J Consult Clin Psychol 1993; 61:506- 15.
57. Safer DJ. Principali considerazioni terapeutiche per il disturbo da deficit dell’attenzione con iperattività. Current Problems in Pediatrics (ed ital), Apr-Ago 95, pag 273-86.
58. Hoffman JB, DuPaul GJ. Psychoeducational interventions for children and adolescents with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000; 9(3):647-61.
59. Pliszka SR, Greenhill LL, Crismon ML, Sedillo A, Carlson C, Conners CK, Mc Cracken JT, Swanson JM, Hughes CW, Llana ME, Lopez M, Toprac MG. The Texas children’s medication algorithm project: report of the Texas consensus conference panel on medication treatment of childhood attention deficit/hyperactivity disorder. Part I. Attention deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2000;39(7):908-19.
60. Bonney H. Treatment of children with hyperkinetic disorders (ADHD) based on communications- and systems analysis. Prax Kinderpsychol Kinderpsychiatr 2000;49(4):285- 99.
61. Hüwer HD. Medikamentöse Therapie der Aufmerksamkheitsstörung bei Kindern. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow- Klinikum 9.10-11.10.98.
62. von Voss H. Kinder entlasten und Eltern befreien. Kinderärztliche Praxis, Sonderheft 2001:3.
63. Smikalla WD. Individuelle medikamentöse Einstellung. Congresso: Aufmerksamkheitsstörung und Hyperaktivität. Diagnose und Therapie. Berlin: Virchow-Klinikum 9.10-11.10.98.
64. Nuzzo V. Lettera al Ministro della Sanità. Forum di Pediatria On Line, ottobre 2000.
65. Martini N. Risposta del Ministro della Sanità alla petizione di Nuzzo sul metilfenidato. Forum di Pediatria On Line, ottobre 2000.